Tortuosidade Coronariana como um Novo Fenótipo para Isquemia sem Doença Arterial Coronariana

Abstract

Coronary artery disease constitutes a great burden in many countries. In many cases, the detection of coronary ischemia by non-invasive imaging may not correlate with the presence of significant coronary stenosis. Therefore, the term "Ischemia with non-obstructive coronary artery (INOCA)" has emerged. Many theories have been proposed for such a phenomenon. Coronary tortuosity (CorT) is one of these etiologies that was found to be associated with subclinical atherosclerosis and increased coronary artery calcium score. 1 Besides, CorT is associated with the same risk factors of ischemia, such as smoking, old age, arterial hypertension and dyslipidemia. 2 CorT was thought to be a phenomenon; however, the association of this phenomenon with multiple cardiovascular disorders augments its clinical impact. Li et al. 3 found that Hypertensive patients with CorT have more incidence of lacunar infarct. 3 Turgut et al. 4 concluded that CorT might indicate impaired left ventricular relaxation. 4 Dogdus et al. 5 proved that CorT negatively affects left ventricular function evaluated by 3D strain parameters with considerable depression of longitudinal deformation of the myocardium. 5